RN Case Manager – Telephonic​/Field – South and South West Kansas

RN Case Manager – Telephonic / Field – South Central and South West Kansas

Field
:
This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

*** Must reside in the state of Kansas. Will support Regions 5 & 6. ***

Travel: 10- 15% travel in South Central to South West Kansas to visit members in person. Mileage reimbursed.

Counties
:
Will support the counties of Finney, Hodgeman, Hamilton, Kearny, Stanton, Morton, Stevens, Grant, Haskell, Seward, Gray, Meade, Ford, Clark, Edwards, Kiowa, Kingman, Barber, Pratt, Stafford.

Work Hours: 8am - 5pm, Monday through Friday.

The Nurse Case Manager for Kansas Medicaid is responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs assessments and coordination of care telephonically and occasionally on-site such as at hospitals, community centers, homes, etc for care coordination and discharge planning.

• Ensures member access to services appropriate to their health needs.

• Conducts assessments virtually and in person to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.

• Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.

• Coordinates internal and external resources to meet identified needs.

• Monitors and evaluates effectiveness of the care management plan and modifies as necessary. Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.

• Negotiates rates of reimbursement, as applicable.

• Assists in problem solving with providers, claims or service issues.

• Requires BA/BS in a health-related field and minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.

• Current, unrestricted RN license in the state of Kansas is required.

• Computer proficiency strongly preferred.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of…